1). We only included patients with diagnosis-relatedgroup (DRG) codes for major joint replacement or reattachment of lower ... Claims data also are subject to coding errors or incomplete capture of patient and clinical data. We addressed this limitation ... Indicators of race and poverty levels of enrollee residential zip codes were obtained through the American Community Survey ( ... major joint replacement or reattachment of lower extremity with Major Complication/Comorbidity). As per Medicare guidelines [8 ...

Among the data elements for each hospitalization were the principal diagnosis, secondary diagnoses, diagnosis-relatedgroup ( ... of that age group) and 80,409 enrollees 65 years or older (38.3 % of that age group). All subsequent analyses included only the ... Co-morbidity measures for use with administrative data. Med Care. 1998;36:8-27.View ArticlePubMedGoogle Scholar. ... principal diagnosis was not clearly identified; if not, we assumed that the first listed diagnosis was the principal diagnosis ...

Many hospitals provide palliative care as part of a package of services under the diagnosis-relatedgroup payment approach. The ... There is limited data on the spending effects of a broad palliative care benefit co-existing with ongoing curative therapy. ... Mental Disorders and Medical Comorbidity, Research Synthesis Report #21, Robert Wood Johnson Foundation, 2011. ... Evaluations of the PACE program generally have found that the program has improved the quality of life and care for enrollees, ...

Currently, NMCSD is designated as an STSF for the treatment of 14 Diagnostic RelatedGroups (DRG). DiagnosisRelatedGroups are ... searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of ... In exchange for lower out of pocket costs, enrollees must agree to choose a primary care manager (PCM) from a list of Prime ... and the presence or absence of specific co-morbidity or complications and who are statistically similar in their inpatient ...

... program enrollees were then matched to enrollees in each of the comparison groups.. A panel data file was constructed with ... A psychiatric patient classifi cation system: an alternative to diagnosis-relatedgroups. Med Care. 1989;27(5): 543-557.. 20. ... Practical considerations on the use of the Charlson comorbidity index with administrative data bases. J Clin Epidemiol. 1996;49 ... and enrollee comparison group membership, which estimated fixed effects common to both groups or unique to the comparison group ...

... around the world emphasize the cost efficiency of each therapy and have implemented policies such as diagnosis-relatedgroups ( ... Data Source. Our data were obtained from Taiwan's National Health Insurance Research Database (NHIRD), which is maintained by ... group, length of stay, CCS, trauma code, and comorbidity. Finally, a logistic regression model was used to assess the risk of ... Y. S. Lai, H. W. Wei, and C. K. Cheng, "Incidence of hip replacement among national health insurance enrollees in Taiwan," ...

Readbag users suggest that Policy and Billing Guidance Ambulatory Patient Groups (APGs) PROVIDER MANUAL is worth reading. The ... They will continue to be paid through the DiagnosisRelatedGroups (DRG) payment methodology. The APG Grouper will ... diagnosis of a complication, diagnosis of a co morbidity, postsurgery, prescription of a new medication or equipment, mental ... Enrollees categorized as `children and adolescents' are those under the age of 19 21. Pregnant and postpartum women will be ...

Appendix C. Examples of Per-Case and DRG Payment Systems DiagnosisRelatedGroups (DRGs) have been used in three State ... We examine whether a classification of hospitals into peer groups could be reasonably used to impute for missing data, and to ... Two of the comorbidity rates were also plausibly positive (abdominal pain and fever of unknown origin) while one was ... Health Care Utilization and Costs of Full-Pay and Subsidized Enrollees in the Florida KidCare Program: MediKids Health Care ...